US11083509B2 - Screw anchor assembly and method of using the same in pedicle screw fixation - Google Patents

Screw anchor assembly and method of using the same in pedicle screw fixation Download PDF

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Publication number
US11083509B2
US11083509B2 US15/608,828 US201715608828A US11083509B2 US 11083509 B2 US11083509 B2 US 11083509B2 US 201715608828 A US201715608828 A US 201715608828A US 11083509 B2 US11083509 B2 US 11083509B2
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Prior art keywords
screw
anchor
screw anchor
anchor assembly
threads
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US20170354442A1 (en
Inventor
Kyoung Tae Kim
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Surgiogen Co Ltd
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Industry Academic Cooperation Foundation of KNU
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/844—Fasteners therefor or fasteners being internal fixation devices with expandable anchors or anchors having movable parts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/686—Plugs, i.e. elements forming interface between bone hole and implant or fastener, e.g. screw
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A61B17/725—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with locking pins or screws of special form
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8605—Heads, i.e. proximal ends projecting from bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8685—Pins or screws or threaded wires; nuts therefor comprising multiple separate parts

Definitions

  • the present disclosure relates to a screw anchor assembly and a method of using the same in pedicle screw fixation, and more particularly, to a screw anchor assembly having a structure capable of increasing fixation power for fixing a spinal bone and facilitating a surgery, and a method of using the screw anchor assembly in pedicle screw fixation.
  • an indirect therapy method using physical therapy and a direct therapy method in which a separate fixation device is installed at a damaged spinal segment to correct and fixate the spine are performed. That is, although physical therapy is performed when a spinal disease is not severe, therapy is performed using a separate spinal fixation device when a disease related to a cervical vertebra, a thoracic vertebra, a lumbar vertebra, a sacrum, and an intervertebral disc, which constitute the spine, is severe.
  • a commonly installed spinal fixation device includes a pedicle (sacrum) screw that is inserted into a pedicle or a sacrum of a vertebra at a predetermined angle and to a predetermined depth, a spinal rod disposed at one side of a spinal segment, and a fixation cap or a coupling and engaging part configured to connect and engage the spinal rod with the pedicle screw.
  • the pedicle screw is inserted and fixed to a pedicle or a sacrum of a vertebra in an appropriate position and direction, the spinal segment is corrected to the normal state using the spinal rod, the spinal rod and the pedicle screw are fixed using the fixation cap or the coupling and engaging part, and then treatment is finished.
  • a larger screw may be inserted into an area at which the screw loosening occurs, the bone near the screw may be filled with cement or the like, or an allograft bone plug may be inserted therein.
  • a screw anchor assembly which is a screw anchor assembly used in pedicle screw fixation, includes a screw having screw threads formed in a longitudinal direction, and a screw anchor inserted into a predetermined area of a spine and having anchor screw threads formed at an inner surface thereof that defines an accommodating part into which the screw is inserted so that the accommodating part is expanded during a process in which the screw anchor is screw-coupled to the screw, wherein a locking step is formed at one end of the screw anchor into which the screw is inserted so that the screw anchor is not drawn into an insertion space in the spine.
  • a method of using a screw anchor assembly in pedicle screw fixation includes inserting a screw anchor into a predetermined area of a spine, inserting an expanding member into an accommodating part defined by an inner surface of the screw anchor so that the screw anchor is attached to the inside of a spine by the expanding member being inserted into the accommodating part and expanding the accommodating part, and inserting a screw into the accommodating part of the screw anchor after removing the inserted expanding member, wherein a locking step is formed at one end of the screw anchor into which the screw is inserted so that the screw anchor is not drawn into an insertion space in the spine.
  • FIG. 1 is a view illustrating a process in which a screw anchor assembly is fixed within a spinal bone according to an embodiment of the present disclosure
  • FIG. 2 is a view illustrating a state in which the screw anchor assembly is separated into a screw anchor and a screw according to an embodiment of the present disclosure
  • FIG. 3 is a view illustrating a state in which the screw anchor and the screw of the screw anchor assembly are coupled according to an embodiment of the present disclosure
  • FIG. 4 is a cross-sectional view of a screw anchor of a screw anchor assembly according to another embodiment of the present disclosure
  • FIG. 5 is a cross-sectional view of a screw anchor of a screw anchor assembly according to still another embodiment of the present disclosure.
  • FIG. 6 is a flowchart of a method of using a screw anchor assembly in pedicle screw fixation according to an embodiment of the present disclosure.
  • FIG. 1 is a view illustrating a process in which the screw anchor assembly is fixed within a spinal bone according to an embodiment of the present disclosure.
  • FIG. 2 is a view illustrating a state in which the screw anchor assembly is separated into a screw anchor and a screw according to an embodiment of the present disclosure.
  • FIG. 3 is a view illustrating a state in which the screw anchor and the screw of the screw anchor assembly are coupled according to an embodiment of the present disclosure.
  • the screw anchor assembly includes a screw anchor 30 and a screw 10 .
  • the screw anchor 30 is a member that is inserted into a predetermined area of a spinal bone prior to the screw 10 instead of the screw 10 being immediately inserted into the area, and allows the screw 10 to be inserted into an accommodating part therein so that fixation power for fixing the screw 10 to the spinal bone is reinforced.
  • the screw anchor 30 has an accommodating part 50 formed therein and is configured to accommodate the screw 10 in a longitudinal direction.
  • Anchor screw threads 40 are formed on an inner surface that defines the accommodating part 50 of the screw anchor 30 , the anchor screw threads 40 may be screw-coupled to screw threads 20 of the screw 10 , which will be described below, and the screw 10 may be accommodated in the screw anchor 30 by such screw coupling. Damage to the screw anchor 30 and/or the screw 10 can be prevented when the screw 10 is inserted into the screw anchor 30 by screw coupling because pitches of the anchor screw threads 40 may be the same as pitches of the screw threads 20 .
  • a locking step 60 may be formed at one end of the screw anchor 30 , which is a part at which the coupling between the screw 10 and the screw anchor 30 begins (refer to D in FIG. 1 ), and the locking step 60 may be formed to expand from the one end of the screw anchor 30 outward or in a radial direction.
  • the screw anchor 30 is not drawn into an insertion space in a spine even when the screw anchor 30 is inserted into the insertion space in the spine and the screw 10 is screw-coupled to the screw anchor 30 because the locking step 60 is present at the one end of the screw anchor 30 . Consequently, the screw anchor 30 including the locking step 60 is fixed at an intended area and serves as an anchor.
  • a part of the locking step 60 that is in contact with the spine may be roughened, or a protrusion may be formed at the part of the locking step 60 in contact with the spine. Accordingly, a frictional force between the locking step 60 and the spine may be increased, and the role of the locking step as an anchor may be further strengthened.
  • fixation of the screw anchor assembly to a spinal bone is semi-permanent, and the fixation power is increased in comparison to a conventional case.
  • a revision surgery recurrence decreases, and a physical and economic burden on a patient is reduced.
  • the other end of the screw anchor 30 which is the opposite side of the one end thereof, may be open and have an opening A formed therein.
  • the screw 10 may pass through the opening A and protrude from the screw anchor 30 when the screw 10 is fixed to the spine through the screw anchor 30 . That is, as illustrated in FIG. 3 , even when a length F of the screw 10 is longer than a length E of the screw anchor 30 , the length of the screw 10 does not need to be concerned about much because the screw 10 can be fixed to the spine by being accommodated in the screw anchor 30 . Accordingly, pedicle screw fixation can be promptly and conveniently performed.
  • any material that is not harmful to the human body may be used as a material of the screw anchor 30 .
  • a plastic material such as polymethylmethacrylate (PMMA) may be used, development using calcium phosphate is planned nowadays, and any of polyether ether ketone (PEEK), a bone material, a bone substitute material, which is a material that is transformed into a bone over time, or an artificial bone may be used.
  • PMMA polymethylmethacrylate
  • PEEK polyether ether ketone
  • a bone material a bone substitute material, which is a material that is transformed into a bone over time, or an artificial bone
  • the screw anchor 30 is formed with the above material, the screw anchor 30 is expanded and widened during a process in which the screw 10 is inserted thereinto. Accordingly, the screw anchor 30 may fill the insertion space in the spine and a coupling force with the spine may be increased, thereby improving fixation power for fixing the screw 10 .
  • the screw anchor 30 When an outer shape of the screw anchor 30 is examined, the screw anchor 30 may have a constant width from the one end to the other end, or may extend with a width gradually narrowing from the one end to the other end. In the latter, the screw anchor 30 can be easily inserted into the spine.
  • the outer shape of the screw anchor is not limited to the above-described outer shapes, and may have any shape as long as the screw anchor can be easily inserted into the spine.
  • an expanding member may be inserted into the accommodating part 50 of the screw anchor 30 so that the screw anchor 30 is expanded and an outer surface of the screw anchor 30 is attached to an inside of the spine. The inserted expanding member is removed after being inserted in this manner, and then the screw 10 is inserted into the accommodating part 50 of the screw anchor 30 .
  • the screw 10 is a type of screw having the screw threads 20 formed in the longitudinal direction.
  • the screw 10 is inserted into the screw anchor 30 by screw coupling and expands the accommodating part 50 of the screw anchor 30 .
  • the screw anchor 30 may be fixed to a spinal bone.
  • the fixation of the screw anchor 30 fixes the screw 10 to the spinal bone and allows the spine to maintain a desired shape.
  • damage to the screw anchor 30 and/or the screw 10 may be prevented when the screw 10 is inserted into the screw anchor 30 by screw coupling because the pitches of the screw threads 20 and the anchor screw threads 40 may be the same.
  • any material that is not harmful to the human body may be used as a material of the screw 10 .
  • a plastic material such as PMMA may be used, development using calcium phosphate is planned nowadays, and any of PEEK, a bone material, a bone substitute material, which is a material that is transformed into a bone over time, or an artificial bone may be used.
  • pedicle screw fixation is performed using the screw anchor assembly including the above-described screw anchor 30 and screw 10 .
  • the screw anchor 30 is inserted and fixed to a pedicle or a sacrum of a vertebra in an appropriate position and direction, and a driver (not illustrated) is used to screw-couple the screw 10 to the accommodating part 50 of the inserted screw anchor 30 .
  • FIG. 4 is a cross-sectional view of a screw anchor of a screw anchor assembly according to another embodiment of the present disclosure.
  • the screw anchor assembly according to another embodiment of the present disclosure may include a locking part B formed along an entirety of or a part of an outer surface of a screw anchor 70 .
  • the locking part B may be a protrusion having an inclined surface, and the inclined surface of the locking part may be inclined toward another end of the screw anchor 70 .
  • a frictional coefficient and a contact area between the screw anchor 70 and a bone surface may be increased, and sufficient pullout strength may be obtained.
  • a screw 10 inserted into the screw anchor 70 can be prevented from falling out of a bone.
  • FIG. 5 is a cross-sectional view of a screw anchor of a screw anchor assembly according to still another embodiment of the present disclosure.
  • a surface of a screw anchor 80 is roughened and includes a roughened outer surface C. Although the roughening is illustrated as being performed on only a part of the surface in FIG. 5 , the entire surface of the screw anchor 80 can be roughened. Due to the roughened outer surface C, a frictional coefficient between the screw anchor 80 and a bone surface is increased, sufficient pullout strength is obtained, and fixation power of the screw anchor 80 is improved.
  • FIG. 6 is a flowchart of a method of using a screw anchor assembly according to an embodiment of the present disclosure in pedicle screw fixation.
  • the method of using the screw anchor assembly according to an embodiment of the present disclosure in pedicle screw fixation includes inserting a screw anchor into a predetermined area of a spine (S 10 ), inserting an expanding member into an accommodating part defined by an inner surface of the screw anchor so that the screw anchor is attached to an inside of the spine by the expanding member being inserted into the accommodating part and expanding the accommodating part (S 20 ), and inserting a screw into the accommodating part of the screw anchor after removing the inserted expanding member, wherein a locking step is formed at one end of the screw anchor into which the screw is inserted so that the screw anchor is not drawn into an insertion space in the spine (S 30 ).
  • the screw anchor 30 is inserted into a predetermined problem area of the spine.
  • the expanding member In the inserting of the expanding member into the accommodating part so that the screw anchor is attached to the inside of the spine by the expanding member being inserted into the accommodating part defined by the inner surface of the screw anchor and expanding the accommodating part (S 20 ), before the screw 10 is inserted into the accommodating part 50 of the screw anchor 30 , the expanding member may be inserted into the accommodating part 50 of the screw anchor 30 to expand the screw anchor 30 and allow an outer surface of the screw anchor 30 to be attached to the inside of the spine. Accordingly, the inside of the screw anchor 30 is expanded, and the screw anchor 30 can be attached to an inner surface of the spine.
  • the screw 10 is inserted into the accommodating part 50 of the screw anchor 30 after removing the inserted expanding member, and here, the locking step 60 is present at the one end of the screw anchor 30 so that the locking step 60 is locked at a spinal segment near the insertion space in the spine and the screw anchor 30 is not drawn into the insertion space.
  • a screw anchor assembly that can be applied to screws of any length so that surgery is facilitated and that has an increased contact area with a spinal bone and sufficient pullout strength so that a screw is reliably fixed and a physical and economic burden is not placed on a patient, and a method of using the screw anchor assembly in pedicle screw fixation can be provided.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Neurology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
US15/608,828 2016-06-08 2017-05-30 Screw anchor assembly and method of using the same in pedicle screw fixation Active US11083509B2 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
KR1020160071012A KR101791004B1 (ko) 2016-06-08 2016-06-08 나사못 앵커 조립체 및 나사못 앵커 조립체를 척추 나사못 고정술에 사용하는 방법
KR10-2016-0071012 2016-06-08

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EP (1) EP3254633B1 (fr)
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GB2512063B (en) * 2013-03-18 2019-05-29 Fitzbionics Ltd Spinal implant assembly
KR102492061B1 (ko) * 2020-06-15 2023-01-25 충남대학교산학협력단 골 고정용 치밀골 나사 보강구조체 및 그를 포함하는 치밀골 나사모듈, 치밀골 나사모듈의 설치방법
KR102522962B1 (ko) * 2021-02-09 2023-04-20 경북대학교 산학협력단 앵커 삽입장치
CN113693699A (zh) * 2021-09-16 2021-11-26 郝定均 一种应用于骨质疏松的爪形椎弓根螺钉

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US20170354442A1 (en) 2017-12-14

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